Second opinions in medical practice

Should doctors discourage the trend of “Second Opinion” resorted to by the patients, after consulting the doctors of their choice? Shouldn’t the doctors refuse to entertain such patient, and send them back to the previous doctor?

 

Absolutely not. Offering a patient the option of a second opinion is one of the major tenets of ethical medical practice. A patient always retains the right to seek confirmation or rebuttal of the diagnosis or treatment offered by the primary doctor when there is lack of confidence, for whatever reason.

Any doctor who is secure in their own reasoning and judgment should not feel threatened or insulted by the request. It’s equally important that the second doctor treat the request with due respect and not belittle the first decision or portray the primary doctor as ignorant or inferior.

If the second opinion concurs with the first, ethics demands that the patient is firmly encouraged to return to the first doctor for further management. The patient; however, retains the right to stay with whoever they feel is in their best interest.

  • A study of almost 6800 patients reported in 2015 showed patient-initiated second opinions led to recommended changes in diagnosis for about 15% and in treatment for about 37% of participants. The larger number of treatment differences is not surprising; a substantial amount of disagreement exists in treatment choices for common conditions. Close to 95% of patients reported they were satisfied with the experience.

Confidence in the skills and integrity of your doctor is the foundation stone for success in treating patients. Lack of trust, triggers the “nocebo” effect. The patient expects harm and, much like in the placebo effect, enhances chances of an unfavourable outcome when there is a lack of perfect trust in the doctor.


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